Summary
Two cases of congenital posterior laryngeal cleft are reported which typify the anaesthetic techniques used for operation on this defect at The Hospital for Sick Children, Toronto. Although this anomaly of the airway is rare, it is potentially curable by surgery and should be included in the differential diagnosis of neonatal respiratory distress aggravated by feeding.
The anaesthetic technique used for microlaryngeal surgery consisted of topical lidocaine, insufflation of oxygen and halothane with supplementary methoxyflurane and spontaneous ventilation. A nasotracheal tube is left in situ postoperatively until laryngeal oedema has subsided. The literature is reviewed and the relevant anaesthetic experience over a ten-year period at The Hospital for Sick Children, Toronto, is summarized.
Résumé
Les auteurs rapportent deux cas de fente laryngée congénitale postérieure et décrivent leur technique anesthésique pour ľintervention corrective de cette anomalie. Bien qu’elle soit rare, cette anomalie peut être traitée par la chirurgie et devrait être incluse dans le diagnostic différentiel de la souffrance respiratoire néonatale aggravée par la tétée. La technique anesthésique utilisée comprenait de la lidocaïne topique, ľinsufflation ďoxygène et ďhalothane supplémenté par du méthoxyflurane en ventilation spontanée. Une canule nasotrachéale fut laissée en place jusqu’á ce que ľœdème laryngé soit résorbé. La littérature est passée en revue et ľexpérience pertinente du Toronto Hospital for Sick Children est résumée.
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References
Ruder. C.B. &Glaser. L.C. Anesthetic management of laryngotracheosophageal cleft. Anesthesiology47: 65 (1977).
Steward, D.J. &Conn, A.W. A clip to retain and support nasotracheal tubes. Canadian Anaesthetists’ Society Journal15: 397–398 (1968).
Fearon. B., Smith C., Delworia-Papadopoulos, M., Levison H. &Swyer, P.R. The idiopathic respiratory distress syndrome in the newborn. Management by tracheostomy and intermittent positive pressure respiration. Annals of Otology. Rhinology and Laryngology4: 1082 (1964).
Richter, C.F. Dissertano Medico de Infanticidoin Artis Obstetriciae, Thesis, Leipzig (1792).
Finlay, H.V.L. Familial congenital stridor. Arch. Dis. Child.24: 219 (1949).
Pettersson, G. Inhibited separation of the larynx and the upper part of the trachea from the esophagus in a newborn: report of a case successfully operated upon. Acta. Chir. Scand.10: 250 (1955).
Evans, J.N.G. Laryngotracheoplasty. Otolaryngol. Clinics of North America10: 119 (1977).
Beazer, R., De Sa J.D., Freeland A.P. &Robertson, N.R.C. Laryngotracheo-oesophageal cleft. Arch. Dis. Child.48: 912 (1973).
Cohen, A.R. Cleft larynx: a report of seven cases. Ann. Otol. Rhinol. Laryngol.84: 747 (1975).
Pillsbury, H.C. &Fischer, N.D. Laryngo-tracheoesophageal cleft: diagnosis, management, and presentation of a new diagnostic device. Arch. Otolaryngol.103: 735 (1977).
Donahoe, P.K. &Hendren, W.H. The surgical management of laryngotracheoesophageal cleft with tracheoesophageal fistula and esophageal atresia. Surgery71: 363 (1972).
Novoselac, M., Dangel, P. &Fisch. V. Laryngotracheoesophageal cleft. J. Ped. Surg.8: 963 (1973).
Burroughs N. &Leape, L. L. Laryngotracheo-esophageal cleft: report of a case successfully treated and review of the literature. Pediatrics53: 516 (1974).
Pracy, R. &Stell, P.M. Laryngeal cleft: diagnosis and management. J. Paryngol. Otol.88: 483 (1974).
Bell, D.W., Christiansen, T.A., Smith. T.E., Jr. &Stucker, F.J. Laryngotracheoesophageal cleft: the anterior approach. Ann. Otol.86: 616 (1977).
Lines, V. Anaesthesia for laryngoscopy and microlaryngeal surgery in children. Anaesth. Intens. Care1: 507 (1973).
Steward, D.J. &Creighton, R.E. General anesthesia for minor surgery in healthy children.Current Problems in Anesthesia and Critical Care Medicine. Year Book Medical Publishers. Inc., Chicago, 1: no. 5(1977).
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Yamashita, M., Chinyanga, H.M. & Steward, D.J. Posterior laryngeal cleft — anaesthetic experiences. Canad. Anaesth. Soc. J. 26, 502–505 (1979). https://doi.org/10.1007/BF03006166
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DOI: https://doi.org/10.1007/BF03006166